INFLAMMATIONS. 135 



every part, therefore, of the antiphlogistic regimen (CXXX. 

 to CXXXL), except the application of cold, ought to be strict- 

 ly observed. 



Another exception to the general rule may occur when the 

 tone of the stomach is weak, and when the patient has been be- 

 fore much accustomed to the use of strong drink ; for then it 

 may be allowable, and even necessary to give some animal food, 

 and a little wine. 



DLXII. That no irritation is to be added to the system 

 during the paroxysms of gout, except in the cases mentioned, is 

 entirely agreed upon among physicians ; but it is a more diffi- 

 cult matter to determine whether, during the time of parox- 

 ysms, any measures may be pursued to moderate the violence 

 of reaction and of inflammation. Dr. Sydenham has given it 

 as his opinion, that the more violent the inflammation and pain, 

 the paroxysms will be the shorter, as well . as the interval be- 

 tween the present and next paroxysm longer : and, if this opi- 

 nion be admitted as just, it will forbid the use of any remedies 

 which might moderate the inflammation ; which is, to a certain 

 degree, undoubtedly necessary for the health of the body. On 

 the other hand, acute pain presses for relief, and, although a 

 certain degree of inflammation may seem absolutely necessary, 

 it is not certain but that a moderate degree of it may answer the 

 purpose ; and it is even probable, that, in many cases, the vio- 

 lence of inflammation may weaken the tone of the parts, and 

 thereby invite a return of paroxysms. It seems to me to be in 

 this way, that, as the disease advances, the paroxysms become 

 more frequent. 



DLXIII. From the last considerations, it seems probable, that, 

 during the time of paroxysms, some measures may be taken to 

 moderate the violence of the inflammation and pain ; and par- 

 ticularly, that, in first paroxysms, and in the young and vi- 

 gorous, blood-letting at the arm may be practised with advan- 

 tage : but I am persuaded that this practice cannot be repeated 

 often with safety ; because blood-letting not only weakens the 

 tone of the system, but may also contribute to produce ple- 

 thora. I believe, however, that bleeding by leeches on the foot, 

 and upon the inflamed part, may be practised and repeated with 

 greater safety ; and I have known instances of its having bee n 



